Impact of a mid-urethral synthetic mesh sling on long-term risk of systemic conditions in women with stress urinary incontinence: a national cohort study.
BJOG
; 129(4): 664-670, 2022 Mar.
Article
in En
| MEDLINE
| ID: mdl-34524725
ABSTRACT
OBJECTIVE:
To compare the incidence of systemic conditions between women who had surgical treatment for stress incontinence with mesh and without mesh.DESIGN:
National cohort study.SETTING:
English National Health Service. POPULATION Women with no previous record of systemic disease who had first-time urinary incontinence surgery between 1 January 2006 and 31 December 2013, followed up to the earliest of 10 years or 31 March 2019.METHODS:
Competing-risks regression was used to estimate hazard ratios (HR), adjusted for patient characteristics, with HR > 1 indicating increased incidence following mesh surgery. MAIN OUTCOMEMEASURES:
First postoperative admission with a record of autoimmune disease, fibromyalgia or myalgic encephalomyelitis up to 10 years following the first incontinence procedure.RESULTS:
The cohort included 88 947 women who had mesh surgery and 3389 women who had non-mesh surgery. Both treatment groups were similar with respect to age, socio-economic deprivation, comorbidity and ethnicity. The 10-year cumulative incidence of autoimmune disease, fibromyalgia or myalgic encephalomyelitis was 8.1% (95% CI 7.9-8.3%) in the mesh group and 9.0% (95% CI 8.0-10.1%) in the non-mesh group (adjusted HR 0.89, 95% CI 0.79-1.01; P = 0.07). A sensitivity analysis including only autoimmune diseases as an outcome returned a similar result.CONCLUSIONS:
These findings do not support claims that synthetic mesh slings cause systemic disease. TWEETABLE ABSTRACT No evidence of increased risk of systemic conditions after stress incontinence treatment with a mesh sling.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Surgical Mesh
/
Urinary Incontinence, Stress
/
Suburethral Slings
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Language:
En
Journal:
BJOG
Journal subject:
GINECOLOGIA
/
OBSTETRICIA
Year:
2022
Document type:
Article
Affiliation country:
United kingdom